your guide to helping your guy

Your Guide to Helping Your Guy

The subject is a delicate one; a man and woman’s intimacy mired by the onset of male sexual issues…erectile dysfunction, premature ejaculation, even low testosterone. A source of stress in the relationship, men often retreat into themselves, not knowing how to seek help. Fortunately, current treatment options are easier to manage than ever before.

“Often men find it difficult to talk about problems relating to sex,” notes Virtua board-certified urologist Mark Fallick, MD. “The good news is today’s treatment alternatives are easier to process than past therapies which were more cumbersome.”

Treatment options for erectile dysfunction

Dr. Fallick often recommends oral medications for erectile dysfunction (ED) first before moving into invasive therapies. “Each patient has a different set of circumstances, so it’s important to individualize treatment,” he states. “There are four oral medications currently available each with variable side effects and distinctive onsets of action.”

Common side effects of these drugs may include headaches, flushing, and stomach upset. The duration of action differs for each, ranging from 4 to 6 hours after ingesting them. The original form of Cialis stayed effective up to 36 hours; today it is available in lower doses in daily form. One drawback may be lack of coverage by your health insurance.

If oral therapy is not an option or effective, other treatments include penile injection therapy, the use of a vacuum erection device that draws blood into the penis, or in severe cases, penile implant surgery which boasts a high satisfaction rate. Regardless of treatment, Dr. Fallick advises seeking professional intervention to explore the best individual options.

Treatment options for premature ejaculation

Patients dealing with the complications of premature ejaculation (PE) have an entirely different set of concerns.“First, I try to uncover how the couple defines PE and what life issues may be contributing to the problem,” explains Dr. Fallick. “According to the American Urological Association, PE is defined as ejaculating sooner than desired, such as just after penetration. But, this is open to interpretation for some couples. The frequency of ejaculation also plays a role here; men who have sex less often ejaculate quicker.”

Treatment for PE changes depending on the patient’s needs. “For some men, I’ve found behavior therapy (exercises) can help correct this problem, “Dr. Fallick notes. “Learning to control the pelvic floor muscles is effective in some cases. Other options include oral medications that are FDA approved for other conditions such as depression. These are prescribed with caution as each anti-depressant can cause mood swings and affect energy level.”

Treatment options for low T

For some men, “low T,” or low levels of testosterone can complicate the sexual experience. Supplemental testosterone can help alleviate this problem; however, not all men should use this.

“Young men with testosterone deficiency syndrome should not go on this type of therapy,” Dr. Fallick clarifies. “The major side effects are decreased sperm production and infertility. Patients should not be started on low T supplements if they expect to conceive children with their partner.”

If conceiving children is not in a man’s future, topical or injection therapies are treatment options. Topical therapy, applied daily, or the testosterone patch can be a highly successful method of increasing a man’s testosterone level.

“More popular now is the long-acting, slow-release pellet placed under the skin in the buttocks area,” Dr. Fallick describes. “This treatment option can last up to four months.” With any testosterone supplement, there is a need to monitor for prostate cancer. Dr. Fallick highly recommends having the prostate regularly evaluated if low T supplements are being administered.

Updated April 10, 2018

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